In 1959, Prinzmetal and his associates1,2 described a form of angina quite different from classic Heberden angina pectoris. Arrhythmia occurred in about 50% of cases during the peak of S-T segment elevation. This paper describes a patient with this variant of angina pectoris, associated with transient, complete atrioventricular (AV) block. Recurrent episodes of syncope would not be controlled in this patient by isosorbide dinitrate and required insertion of a transvenous demand pacemaker. Advanced degree of AV block is a rare complication and only few cases have been reported.1-4 Because of this rarity and the subsequent management of our patient, we believe this report may be of general interest.
A 76-year-old black man was admitted to the Veterans Administration Hospital in Cleveland because of loss of vision in the left eye. He had been treated for glaucoma for many years, losing vision in his right eye in